Written Answers Nos. 163-182
163. Deputy Marc MacSharry asked the Minister for Health the composition of the HSE drugs group according to profession, by individual profession; the number of persons that sit on the group; the length of time each member serves on the committee; the membership of the committee; and if he will make a statement on the matter. [48359/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
164. Deputy Mary Lou McDonald asked the Minister for Health if his attention has been drawn to the fact that the HSE's financial reporting systems do not provide for sub-speciality reporting and as a result the HSE cannot isolate specific spend for CAMHS and other mental health services; and if he will make a statement on the matter. [48360/17]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
165. Deputy Mary Lou McDonald asked the Minister for Health the date by which the HSE's mental health division will complete its allocation and costing model that will provide for detailed annual expenditure reporting. [48361/17]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
166. Deputy Catherine Connolly asked the Minister for Health the steps that have been taken for the provision of a proper and adequate ambulance service for a region (details supplied); and if he will make a statement on the matter. [48362/17]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
167. Deputy Mary Butler asked the Minister for Health his plans to have the medical device FreeStyle Libre for treatment of persons with type 1 diabetes made available under the LTI scheme; and if he will make a statement on the matter. [48363/17]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
168. Deputy Pat Deering asked the Minister for Health if a connection is being made between the HPV vaccine and the onset of symptoms experienced by 628 women; and if he will make a statement on the matter. [48368/17]
View answerI am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. An illness that occurs around the time a vaccine is given and is already known to be common in adolescence does not imply the vaccine caused the problem. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. It is important to reassure people that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. As there is no scientific evidence that the vaccine causes long term illnesses, the HPV vaccine cannot be held responsible for these illnesses.
As Minister for Health I fully support the HPV immunisation programme and its aim to increase uptake rates of this important vaccine.
169. Deputy Bobby Aylward asked the Minister for Health if the HSE drugs committee group met on 14 September 2017 to discuss a drug (details supplied); if a decision was made to reimburse the drug; and if he will make a statement on the matter. [48371/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
170. Deputy Bobby Aylward asked the Minister for Health the witnesses outside of the Health Service Executive drugs group who presented evidence at hearings in respect of reimbursement of a drug (details supplied); and if he will make a statement on the matter. [48372/17]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
172. Deputy Gerry Adams asked the Minister for Health if he will commission an audit of Our Lady of Lourdes Hospital, Drogheda by the national treatment purchase fund; when this will be undertaken; and if he will make a statement on the matter. [48392/17]
View answer173. Deputy Gerry Adams asked the Minister for Health the other hospitals for which he will commission an audit from the national treatment purchase fund; and when these audits will be undertaken. [48393/17]
View answerI propose to take Questions Nos. 172 and 173 together.
The National Scheduled Care Audit and Quality Assurance Review Programme were established in the National Treatment Purchase Fund in 2014 in conjunction with the National Director of Acute Hospitals, Health Service Executive. This programme is delivered under the NTPF’s Statutory Instrument (2004, S.I. No. 179) “to collect, collate and validate information in relation to persons waiting for hospital treatment and to put in place information systems for that purpose”
The aim and overall objective of this programme is:
1. To audit that hospitals are returning complete, accurate, validated patient information for inpatient and outpatient waiting lists.
2. To audit that hospitals have implemented key internal management practices to manage demand, capacity and productivity ensuring equitable access to treatment for patients on inpatient and outpatient waiting lists.
The RTE Investigates programme in February highlighted the deeply moving personal stories of people waiting for treatment in public hospitals. Following the programme I was determined that the health service must learn from those patients’ experiences. As a result, I asked the NTPF to examine waiting list practices in the hospitals highlighted in the programme.
The NTPF has now reported to me on its findings and last week I published the finding of the Special Audit. The NTPF’s report has a number of actions to be implemented by the individual hospitals and across the public hospital system as a whole, to drive better performance in terms of how waiting lists are managed in our hospitals.
Arising from the audit, the HSE has taken immediate steps to put in place a plan at national level that will focus on driving system-wide implementation of performance and process improvement in waiting list management. As part of this plan, the HSE will assess, review and oversee implementation of performance and process improvement to address the Special Audit findings across all hospitals.
Addressing the Special Audit Report’s recommendations will be a priority for the HSE for the remainder of the year and will form a core pillar of the Waiting List Action Plans for 2018 as well as the HSE’s National Service Plan. In addition I have asked the NTPF to develop a plan to extend the Special Audit process in 2018 to other public acute hospitals.
174. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 476 of 11 April 2017, if he will provide the actuarial models and estimates used to create projections of costs for the clinical indemnity scheme. [48406/17]
View answerI regret that it is not possible, for reasons of commercial sensitivity, to provide the information requested. The State Claims Agency advises that the contents of the actuarial reports commissioned by it, in respect of the operation of the Clinical Indemnity Scheme, includes very sensitive commercial detail which if published in any public forum could have significant detrimental effects on the Agency's ability to settle claims, on best possible terms, within the terms of its remit.
175. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [48414/17]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
176. Deputy Noel Grealish asked the Minister for Health the waiting list for child scoliosis surgery at Temple Street Children's Hospital; and if he will make a statement on the matter. [48432/17]
View answer177. Deputy Noel Grealish asked the Minister for Health the waiting list for child scoliosis surgery at Our Lady's Children's Hospital, Crumlin; and if he will make a statement on the matter. [48433/17]
View answer178. Deputy Noel Grealish asked the Minister for Health the waiting list for child scoliosis surgery at the national children's hospital, Tallaght; and if he will make a statement on the matter. [48434/17]
View answer179. Deputy Noel Grealish asked the Minister for Health the waiting list for child scoliosis surgery at Cappagh National Orthopaedic Hospital; and if he will make a statement on the matter. [48435/17]
View answerI propose to take Questions Nos. 176 to 179, inclusive, together.
In relation to the queries raised, as they are service matters, I have asked the HSE to respond to you directly.
180. Deputy Bernard J. Durkan asked the Minister for Health the extent to which various increased budgetary provisions throughout the health service announced in budget 2018 are likely to positively impact on the delivery of health services in the coming year; and if he will make a statement on the matter. [48439/17]
View answerThe gross current budget for the Health Sector in 2018 is €14.798 billion and represents a €646m (4.6%) increase over the 2017 allocation of €14.152 billion. It is expected that the funding provided will result in better access for patients, more help for families and more supports for disability, mental health and older and vulnerable people. The exact quantum of services to be delivered in 2018 will be set out in detail in the 2018 National Service Plan currently being prepared by the Health Service Executive.
The additional funding provided will mean more front-line staff for the health service across the acute, mental health, disability, primary and community care sectors. Increases in nursing numbers will be realised as we continue to extend and roll out the Task-force on Safe Staffing.
Some of the key areas where funding will be targeted and where it is hoped to have a positive impact on the delivery of services in the coming year are highlighted below.
New access programme
Reducing waiting times for patients and improving access to our health services is a key priority. The significant increase in funding to the NTPF in 2018 should ensure that additional procedures will be offered to patients across a range of specialties and procedures. This means that more patients will be seen in our hospitals and fewer patients should encounter long waiting times. In addition, funding to improve access to emergency care in 2018 will enable the opening of additional hospital capacity, including new beds and by providing additional diagnostic services and surge capacity to reduce Emergency Department overcrowding.
Additional funding will also be available to progress key strategic initiatives which will enable progress in the phased implementation of the National Cancer Strategy, the National Maternity Strategy, and in the continued development of the National Ambulance Service. Extra funding for home care packages and transitional care beds should also further strengthen supports for older people, particularly to facilitate speedier discharge from acute hospitals over the winter period.
Shift to Primary Care
The provision of a new primary care fund will enable a range of initiatives to be progressed in 2018 which will focus on disease prevention and early intervention, particularly through the further development and expansion of GP services, Community Intervention Teams and the recruitment of additional therapy posts and advanced nurse practitioners. Throughout 2018 there will also be a continued focus on the development of primary care centres and primary care teams.
Expanding and developing Mental Health Services
The provision of an additional €35 million for 2018 will help build on the work commenced in 2017 on the enhancement of Community Teams for Children, Adults, Later Life and Mental Health Intellectual Disability services. It will also help continue the move towards a full 24/7 service with an initial focus on increasing the provision of services on a 7-day-a-week basis. Further improvements are also planned to services for Eating Disorders and Dual Diagnosis.
Supporting Disability Services
Additional funding for Disability Services will be focused on a number of priority areas arising from ongoing demographic changes including residential places, respite places, Personal Assistance and Home Support service hours.
Supporting the most vulnerable
A focus on the health needs of the most vulnerable groups in society, who can experience health inequalities, have difficulties accessing services and present with multiple, complex health and support needs will also be maintained. In this context, significant additional funding has been approved to address the health needs of people who are homeless and have mental health and addiction issues in line with Rebuilding Ireland.
Additional funding has also been provided to the Healthy Ireland Fund which will support partnership working in different sectors and communities to help ensure policies under Healthy Ireland have an impact at local level and empower people to improve their own health and well-being.
181. Deputy Bernard J. Durkan asked the Minister for Health the staffing levels throughout the public health sector at all levels in the hospitals and community care; the extent to which they have been augmented in recent years; and if he will make a statement on the matter. [48440/17]
View answerThe Government has allocated an additional €646 million in current expenditure to Health in Budget 2018, including funds for an additional 1,800 front line staff. The overall Health budget for 2018 is almost €15.3 billion. The HSE is currently finalising the 2018 Service Plan and will allocate the additional posts in accordance with service demands.
Following the economic downturn there was a significant fall in numbers employed across the health services, with the exception of consultant and NCHDs given the need to move towards a consultant delivered service and to improve compliance by NCHDs with the provisions of the European Working Time Directive. The attached table shows that the total number of staff employed in the public health services, including home helps, has increased significantly in the past three years as additional funding has become available, with an increase of over 10,000 staff.
Personnel Census below shows data For All Agencies Broken Down by Staff Category for September 2007, September 2014 and September 2017:
|
30/0930/2007 |
30/09/2014 |
30/09/2017 |
|
|
Staff Category |
WTE (excluding Career Break) |
WTE (excluding Career Break) |
WTE (excluding Career Break) |
|
Medical/ Dental |
8,100.05 |
8,713.10 |
10,038.03 |
|
Nursing |
38,965.48 |
34,335.54 |
36,170.25 |
|
Health & Social Care Professionals |
15,762.47 |
13,417.00 |
15,631.74 |
|
Management/ Admin |
18,421.12 |
14,987.28 |
17,478.79 |
|
General Support |
13,306.48 |
9,474.39 |
9,500.11 |
|
Patient & Client Care |
13,306.48 |
9,474.39 |
9,500.11 |
|
Total |
117,663.02 |
102,134.39 |
112,628.59 |
The need to increase the numbers of consultants, doctors, nurses and midwives in the public health service is a priority for this Government, the Minister for Health and the HSE despite a backdrop of global shortages in health professionals. At the end of September 2017 there were 2,951 whole time equivalent consultants in the public health services. This is 103 more than the end September 2016 figure and an increase of over 650 (665) in the past decade. At the end of September 2017 there were 6,286 whole time equivalent NCHDs, an increase of 311 compared with the end of September 2016 number and an increase of over 1,394 in the past decade.
Nursing and midwifery numbers at the end of September 2017 stood at 36,170 whole time equivalents. The number of nursing posts has increased by 632 in the 12 months from end September 2016 and by over 2,000 in the four years from end September 2013 to end September 2017. The Nursing Recruitment and Retention Agreement concluded with the INMO and SIPTU Nursing earlier this year committed to increasing the number of nurses and midwives by 1,224 additional permanent posts in 2017. The recent quarterly progress report on the Agreement from the HSE (30th Sept 2017) states that the HSE has filled 20% of the target posts. It is important to bear in mind however that most student nurses graduate in the autumn. The HSE is currently concluding the process of offering all graduating nurses and midwives permanent contracts. This is expected to deliver a significant increase in staff nurse numbers between now and year-end, given that most students who complete their training at the end of August are recruited in the 4th quarter, following registration.
182. Deputy Bernard J. Durkan asked the Minister for Health the current bed shortfall throughout the public health system; and if he will make a statement on the matter. [48441/17]
View answerWork on the Health Service Capacity Review is continuing to progress. As I have previously stated, the Review will have a wider scope than previous exercises and will examine key elements of primary and community care infrastructure in addition to hospital facilities. A Steering Group is overseeing the project, with support from external consultants commissioned to provide technical, analytical and engagement expertise. An independent international peer review group is involved in ongoing review and validation of the methodology and approach. My Department has also undertaken a public consultation process to ensure that stakeholder views are fed into the process.
The findings from the Review will provide a basis for determining both the extent of capacity requirements, including bed numbers, over the next 15 years and the type of capacity that is needed at a national and regional level. The emerging findings from the review will inform the development of a new 10 year national capital plan later this year.
I expect to receive the final report of the Capacity Review by the end of the year.
